Speech Notes: Health Annual Report and Financial Oversight Debate

Madam Speaker, Hon Premier, Honourable members of the House, Officials and visitors, I greet you all.

It is not easy to reflect on the slow but steady collapse of an entire provincial department, particularly when it is responsible for the health of millions of citizens. It is even worse when one has to acknowledge that a fair portion of the blame for this collapse needs to be placed at the feet of officials who work in the department. Let me elucidate….

It is widely rumoured that professional staff within district and provincial hospitals have worked in cahoots with officials to remove patient information records, which then mysteriously become the subject of medico-legal claims against the department of Health.

The Minister of Justice, Michael Masutha, and the Minister of Health, Aaron Mostoaledi, have acknowledged that since 2013, more than R60 billion has been paid out countrywide in settlements against medico-legal claims that could have been defended. The State Attorney’s Office of the Eastern Cape is one of the biggest offenders in this regard. They work with unscrupulous lawyers and purposely lose cases. They then share the spoils when the claims are settled.

This is absolutely shocking. But the looting of the Department of Health does not stop there. Madam Speaker, through you I would urge the MEC to scrutinise contracts with outside companies very carefully, because it is alleged that these companies are not, in fact, outside companies, but officials hiding behind the names of their wives and / or girlfriends, and doing undeclared business with the state.

It would be wise of her to find out, for example, who the owners are of the BEE company that owns the U-rent Fleet management business that the Department of Health makes use of , and why the department is allegedly paying this company more than double what they would pay any other fleet management company.

Of the gravest concern to me is that if I, as a member of the Official Opposition, am told so much about the shenanigans within the Department, then this information must be widely known. What steps are being taken to act against such criminal elements within the department? Or is “consequence management” just a catch phrase that applies only to people who are not political cadres?

While these officials are seemingly milking the department for all that its worth, the services that are offered to the public are diminished more and more with each passing day. The real work of the department of Health, the actual delivery of health care services to the people, is being compromised at the expense of a bloated and corrupt administration. Hill of hope? No! A sippery slope.

The diminishing services have already resulted in the deaths of many patients, and will result in more. For example, a dangerously understaffed EMS service resulted in a young woman in Alicedale, who was experiencing complications in labour, waiting for many hours for an ambulance to fetch her. The result – she lost her baby, and after a week in a coma, she too passed away.

More recently, it was announced last week that the Catheterization Laboratory, known as the Cath Lab at Provincial Hospital, has now finally broken beyond repair. The only other Cath Lab in the Province, which is housed in the Nelson Mandela Academic Hospital in Mthatha has no staff, despite promises that this unit would be up and running by the 1st of October. So as a result hundreds of heart patients who require regular treatment in the cath lab in order to survive, are at risk. This is a catastrophe in waiting. Hill of hope? No – a slippery slope!
Clinics and hospitals, whether they are urban or rural, are buckling under the strain of staff shortages and massively increased administrative demands. Ironically, there is a brand new computer sitting on almost every nurse’s desk in the province. When asked whether this new technology has been of assistance in addressing the patient records crisis, the nurses and sisters laugh.

They ask, “When do you think we have time to switch a computer on? We don’t even have the time to fill in the new patient health records – there they are, lying in the corner untouched. We spend ten to eleven hours a day JUST seeing patients. There is no lunch break. There is no toilet break. There is nobody to do the admin. Do we choose to spend hours filling in paperwork, while patients die in the waiting rooms, or do we practise the profession of nursing? We choose to do the latter.”

Until as recently as five years ago, there were mobile clinic services in most of the rural areas across the province. These clinics provided chronic medication on some days, and family planning treatments on others. There are hardly any more of these mobile clinics in use today. This was a vital service to rural dwellers. Now they have no option but to spend what little money they have on public transport to and from the closest clinic. Once again, an excellent service has been compromised at the expense of the fatcat officials. Hill of hope? No – a slippery slope!

While we celebrate 16 days of activism against woman and child abuse, why is such abuse allegedly swept under the carpet in the Department of Health? Why are senior managers in the Department allegedly allowed to repeatedly sexually harass women, with no consequences? What does this say about the leadership in the department?

When these men allegedly brag about being so powerful that nobody can touch them, what does this say about the accountability of top management? And what does this say about a government that publically professes to fight the scourge of sexual abuse, but privately protects the offenders? This is a disgrace, and every official who knows about such behaviour and does not take action, is guilty of perpetuating this disgraceful behaviour. You are also abusers. Shame on you!

If this department is ever to recover financially and attempt to recover from the severe reputational damage that has been caused by its own officials, then I would suggest a massive spring clean, starting at the very top of the heap of officialdom. Madam Speaker, I would suggest that this will require nerves of steel, political backbone and a very strong resolve.

The Democratic Alliance firmly believes that the NHI proposals are over-centralised and unnecessary. The bottom line is that we cannot afford them. The NHI is not a magic wand that you can wave over a failing health system in the hope that it will become functional. If the current system is failing through corruption and poor management, then the new system will suffer the same fate.

Until you address the root causes of corruption and poor management, and expunge them from the system, it will never be functional. You will continue down the slippery slope until the health care system in this province fails completely.

The Democratic Alliance believes firmly in universal access to healthcare for all. However, this can be achieved with the current regional management model, as in the Western Cape, provided the executive is politically accountable. When there is no corruption in the system, there is money to improve it. In the Western Cape, seven rural community health facilities were built this year alone.

Good healthcare requires professional, quality staff who receive the necessary administrative support. Strong community based structures with doctor driven primary health care systems, allow for localised and excellent service delivery.

As a result, the life expectancy of citizens in the DA – led Western Cape is now five years higher than the rest of the country. The strengths of the private sector can be, and are, leveraged through public – private partnerships. These fundamental pillars of effective healthcare delivery would set you on the path up the hill of hope. Only the Democratic Alliance can get you there!

The Democratic Alliance accepts the report.